Improving care for hospitalized elderly patients: The effects of an e-learning tool.

Research question trial:

Does the use of a complementary e-learning tool improve the implementation of the delirium part of the Vulnerable elderly project?



Design:

A stepped wedge cluster randomized controlled trial.

The Vulnerable elderly project is a nationwide quality improvement project aimed at care for hospitalized elderly (70 years and older). Four healthcare problems are addressed within this project: delirium, falls, malnutrition and functional decline. For our research questions we focus on the delirium aspect of the project.

The Vulnerable elderly project is a part of a larger patient safety program in the Netherlands, similar to the 100.000 Lives campaign in the United States and the Safer Healthcare Now! campaign in Canada.



Methods for data gathering:

Data will be gathered in 20 Dutch hospitals, all of which are still at the beginning stages of the implementation of the Vulnerable elderly project. One internal medicine ward and one surgical ward of each hospital will participate in the study. Patient record reviews of patients 70 years or older will be the main source of data. During 11 months research-nurses will review 10 records per ward per month. All reviews will take place within the same week of the month, using records of patients still admitted or released within the precious week. From these records data concerning the implementation of the Vulnerable elderly project will be gathered.



Intervention:

Every month two randomly selected hospitals will receive access to an e-learning tool regarding delirium (one aspect of the Vulnerable elderly project). This stepped wedge design will result in data from all hospitals for the control and for the intervention group.

The implementation of the delirium part of the Vulnerable elderly project will improve when nurses have completed an e-learning tool regarding delirium care for elderly patients.

Monthly record review of still admitted patients or recently released patients in all participating wards. No follow-up per patient.

E-learning tool for at nurses, aimed at improving knowledge, skills and attitude regarding delirium care for elderly patients. This tool was developed by Noordhoff, in cooperation with a hospital.
Nurses working in the participating wards will be given access to the e-learning tool for a period of 3 months. The estimated time needed to complete the tool and the knowledge test before and after the tool is 4 hours. The period in which each ward is given access is assigned randomly.